scholarly journals Can TasP Approaches Be Implemented in Correctional Settings?: A review of HIV testing and linkage to community HIV treatment programs

2016 ◽  
Vol 27 (2A) ◽  
pp. 71-100 ◽  
Author(s):  
Katherine S. Elkington ◽  
Jessica Jaiswal ◽  
Anya Y. Spector ◽  
Heidi Reukauf ◽  
James M. Tesoriero ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Hiv Treatment ◽  
Treatment Programs ◽  
Correctional Settings

scholarly journals Impact of Xpert MTB/RIF on Antiretroviral Therapy-Associated Tuberculosis and Mortality: A Pragmatic Randomized Controlled Trial

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
L. Mupfumi ◽  
B. Makamure ◽  
M. Chirehwa ◽  
T. Sagonda ◽  
S. Zinyowera ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Limited Resource ◽  
Hiv Treatment ◽  
Treatment Programs ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Pragmatic Randomized Controlled Trial ◽  
Randomized Controlled ◽  
Art Initiation

Abstract Introduction.  GeneXpert® MTB/RIF (Xpert) is now widely distributed in high human immunodeficiency virus (HIV)/tuberculosis (TB)-burden countries. Yet, whether the test improves patient-important outcomes within HIV treatment programs in limited resource settings is unknown. Methods.  To investigate whether use of Xpert for TB screening prior to initiation of antiretroviral treatment (ART) improves patient-important outcomes, in a pragmatic randomized controlled trial we assigned 424 patients to Xpert or fluorescence sputum smear microscopy (FM) at ART initiation. The primary endpoint was a composite of 3-month mortality and ART-associated TB. Results.  There was no difference in overall TB diagnosis at ART initiation (20% [n = 43] Xpert vs 21% [n = 45] FM; P = .80), with most patients in both groups treated empirically. There was no difference in time to TB treatment initiation {5 days (interquartile range [IQR], 3–13) vs 8 days [IQR, 3–23; P = .26]} or loss to follow-up (32 [15%] vs 38 [18%]; P = 0.38). Although a nonsignificant reduction in mortality occurred in the Xpert group (11 [6%] vs 17 [10%]; 95% CI, −9% to 2%; P = .19), there was no difference in the composite outcome (9% [n = 17] Xpert vs 12% [n = 21] FM; difference −3%; 95% CI, −9% to 4%). Conclusions.  Among HIV-infected initiating ART, centralized TB screening with Xpert did not reduce the rate of ART-associated TB and mortality, compared with fluorescence microscopy.

scholarly journals International Normalized Ratio (INR) Increases amongst Two Patients Living with HIV on Warfarin after Being Switched from a Nevirapine to a Dolutegravir-Based Antiretroviral Regimen

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Natalie Sang ◽  
Sonak Pastakia ◽  
Samuel Nyanje
Keyword(s):  
Drug Interactions ◽  
International Normalized Ratio ◽  
Hiv Treatment ◽  
Treatment Programs ◽  
Cytochrome P450 Enzyme ◽  
Close Monitoring ◽  
Medication Regimen ◽  
Emergency Plan ◽  
First Case ◽  
Living With Hiv

The increased use of dolutegravir-based regimens in the treatment of HIV is unmasking drug interactions, particularly in patients who were previously on nevirapine. Nevirapine is an enzyme inducer and increases the dosing requirements for cytochrome P450 enzyme substrates including warfarin. Upon discontinuing nevirapine, close monitoring of drugs with narrow therapeutic indices is paramount since dosing requirements may significantly reduce, increasing the probability of toxicity development. We present two cases describing interactions experienced by patients living with HIV, while transitioning from nevirapine to dolutegravir-based HIV regimens. The first case describes a 70-year-old man living with HIV and diabetes, while the second case describes a 60-year-old woman living with HIV. They were diagnosed with unprovoked deep vein thrombi, and while receiving treatment with warfarin, their HIV medication regimen was changed from lamivudine, zidovudine, nevirapine, and septrin to lamivudine, tenofovir, dolutegravir, and septrin. During the weeks following this switch, warfarin requirements decreased resulting in supratherapeutic INRs. With the continued promotion of dolutegravir-based HIV regimens as the preferred option for the treatment of HIV in President’s Emergency Plan for AIDS Relief (PEPFAR) supported HIV treatment programs in Africa, clinicians must be aware of the potentially life-threatening consequences of switching antiretroviral regimens. It is hoped that a greater awareness of this potential side effect could lead to increased monitoring and prevention of the consequences of drug interactions.

scholarly journals Prevalence and factors associated with use of khat: a survey of patients entering HIV treatment programs in Ethiopia

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Alan R. Lifson ◽  
Sale Workneh ◽  
Tibebe Shenie ◽  
Desalegn Admassu Ayana ◽  
Zenebe Melaku ◽  
...  
Keyword(s):  
Hiv Treatment ◽  
Treatment Programs ◽  
Factors Associated

State Laws Governing HIV Testing in Correctional Settings

2016 ◽  
Vol 22 (1) ◽  
pp. 28-40 ◽  
Author(s):  
Brett A. Tarver ◽  
Jenny Sewell ◽  
Nadia Oussayef
Keyword(s):  
Hiv Testing ◽  
State Laws ◽  
Correctional Settings

Stigma, sexual risk and desire for HIV tests in Ghana

Sexual Health ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 110 ◽  
Author(s):  
Emmanuel F. Koku
Keyword(s):  
Hiv Prevention ◽  
Hiv Testing ◽  
Treatment Programs ◽  
Negative Interaction ◽  
Sexual Behaviours ◽  
Hiv Test ◽  
Related Stigma ◽  
Risky Sexual Behaviours ◽  
Positive Effect

Background: Although various HIV prevention and treatment programs have been implemented in Ghana since 2003, desire for and uptake of HIV testing is still low, owing largely to HIV-related stigma. This study examined the effect of stigma on desire for HIV testing, while controlling for socio-demographic and other influences. Method: The study used data from the 2003 Ghana Demographic and Health Survey to regress desire for an HIV test on levels of stigma while controlling for selected socio-demographic, socio-cognitive and socio-behavioural covariates. Results: The study revealed significant associations between several socio-demographic and socio-cognitive variables and the desire for an HIV test. For example, both male (adjusted odds ratio (AOR) = 0.41; 95% confidence interval (CI) = 0.24–0.72) and female (AOR = 0.62; 95% CI = 0.41–0.93) respondents in the wealthiest households, and those who know someone infected with HIV (AOR = 0.65; 95% CI = 0.43–1.00) have lower odds of desiring an HIV test. The study showed a significant but negative interaction between risky sexual behaviours and community stigma (AOR = 0.44; 95% CI = 0.19–0.67), indicating that the positive effect of risky sex on HIV testing is attenuated among females who live in communities with high levels of stigma. Conclusion: Since community-level education and risk reduction programs have demonstrable influences on reducing HIV stigma, it is imperative that the Ghana government’s ongoing anti-stigma campaigns and other HIV prevention programs recognise the role of community stigma in influencing HIV testing decisions, especially in the context of risky sexual behaviours.

scholarly journals Access to Basic HIV-Related Services and PrEP Acceptability among Men Who Have sex with Men Worldwide: Barriers, Facilitators, and Implications for Combination Prevention

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
George Ayala ◽  
Keletso Makofane ◽  
Glenn-Milo Santos ◽  
Jack Beck ◽  
Tri D. Do ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Service Provider ◽  
Service Providers ◽  
Hiv Treatment ◽  
Service Access ◽  
Cross Sectional ◽  
Combination Prevention ◽  
Gay Community ◽  
Hiv Prevention Strategies ◽  
Sex With Men

Introduction. Men who have sex with men (MSM) are disproportionately impacted by HIV globally. Easily accessible combination HIV prevention strategies, tailored to the needs of MSM, are needed to effectively address the AIDS pandemic. Methods and Materials. We conducted a cross-sectional study among MSM (n=3748) from 145 countries from April to August 2012. Using multivariable random effects models, we examined factors associated with acceptability of preexposure prophylaxis (PrEP) and access to condoms, lubricants, HIV testing, and HIV treatment. Results. Condoms and lubricants were accessible to 35% and 22% of all respondents, respectively. HIV testing was accessible to 35% of HIV-negative respondents. Forty-three percent of all HIV-positive respondents reported that antiretroviral therapy was easily accessible. Homophobia, outness, and service provider stigma were significantly associated with reduced access to services. Conversely, community engagement, connection to gay community, and comfort with service providers were associated with increased access. PrEP acceptability was associated with lower PrEP-related stigma, less knowledge about PrEP, less outness, higher service provider stigma, and having experienced violence for being MSM. Conclusions. Ensuring HIV service access among MSM will be critical in maximizing the potential effectiveness of combination approaches, especially given the interdependence of both basic and newer interventions like PrEP. Barriers and facilitators of HIV service access for MSM should be better understood and addressed.

Provision of Hepatitis C Education in a Nationwide Sample of Drug Treatment Programs

2003 ◽  
Vol 33 (1) ◽  
pp. 107-117 ◽  
Author(s):  
Janetta Astone ◽  
Shiela M. Strauss ◽  
Zdravko P. Vassilev ◽  
Don C. Des Jarlais
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Treatment ◽  
Hiv Testing ◽  
Drug Users ◽  
Treatment Programs ◽  
Educational Services ◽  
Drug Treatment Programs

Hepatitis C virus (HCV) has reached epidemic proportions among drug users, and drug programs are in a unique position to provide each of their patients with HCV education. Using a nationwide sample ( N = 434) of drug treatment programs, we report the results of a logistic regression analysis that differentiates programs providing HCV education to all of their patients versus programs that do not. Fifty-four percent of the programs provide HCV education to all of their patients. Programs are about four and a half times as likely to provide HCV education to all patients if they dispense methadone; almost four times as likely to provide this service if they educate most of their staff about HCV; twice as likely if they are residential; and almost twice as likely if they conduct HIV testing on-site. Our findings indicate that there is a need to increase HCV educational services in drug treatment programs.

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